F H Loh1, N Hameed, S C Ng. 1. Department of Obstetrics & Gynaecology, National University Hospital, Singapore. fh_loh@pacific.net.sg
Abstract
OBJECTIVE: To assess the impact of minimal access surgery in replacing traditional open approach of surgery for benign gynaecological pathology. SETTING: Gynaecological unit in a university hospital. METHODOLOGY: All surgical procedures for the treatment of ectopic pregnancy, benign ovarian cyst, myomectomy, and hysterectomy for benign gynaecological pathology over a 10-year period (1991 to 2000) were studied. The percentages of procedures performed with the minimal access approach were compared with the traditional open approach over the study period. FINDINGS: The percentage of ectopic pregnancies treated laparoscopically has increased from a low of 27% in the initial two-year period of 1991-92 to stabilise at approximately 70% at the end of the decade. Laparoscopic approach for the treatment of benign ovarian cysts constituted just 31% of cases in the initial period (1991-92) and rose steadily to stabilise at approximately 50% of cases during the last four years of the decade. The proportion of advanced minimal access procedures such as myomectomy and hysterectomy increased at a more gradual pace during the decade. By 1999-2000, laparoscopic and hysteroscopic myomectomy constituted about 30% of all myomectomies but laparoscopic hysterectomy accounted for just about 5% of all hysterectomies performed. CONCLUSIONS: Minimal access surgery has largely replaced the open approach for the treatment of ectopic pregnancy and benign ovarian cysts. Advanced minimal access procedures such as myomectomy and hysterectomy showed a rising trend through the decade, but still accounted for a minority of procedures at the end of the decade.
OBJECTIVE: To assess the impact of minimal access surgery in replacing traditional open approach of surgery for benign gynaecological pathology. SETTING: Gynaecological unit in a university hospital. METHODOLOGY: All surgical procedures for the treatment of ectopic pregnancy, benign ovarian cyst, myomectomy, and hysterectomy for benign gynaecological pathology over a 10-year period (1991 to 2000) were studied. The percentages of procedures performed with the minimal access approach were compared with the traditional open approach over the study period. FINDINGS: The percentage of ectopic pregnancies treated laparoscopically has increased from a low of 27% in the initial two-year period of 1991-92 to stabilise at approximately 70% at the end of the decade. Laparoscopic approach for the treatment of benign ovarian cysts constituted just 31% of cases in the initial period (1991-92) and rose steadily to stabilise at approximately 50% of cases during the last four years of the decade. The proportion of advanced minimal access procedures such as myomectomy and hysterectomy increased at a more gradual pace during the decade. By 1999-2000, laparoscopic and hysteroscopic myomectomy constituted about 30% of all myomectomies but laparoscopic hysterectomy accounted for just about 5% of all hysterectomies performed. CONCLUSIONS: Minimal access surgery has largely replaced the open approach for the treatment of ectopic pregnancy and benign ovarian cysts. Advanced minimal access procedures such as myomectomy and hysterectomy showed a rising trend through the decade, but still accounted for a minority of procedures at the end of the decade.